Collective Stress Syndrome

To the Editor.—  In the last few years, we have observed among schoolchildren several outbreaks of acute illness that probably represent instances of mass hysteria. In each situation, we have been impressed with the entirely negative and distressing implications of the term "hysteria." For the persons involved (and their parents), the term "mass hysteria" is perceived as an affront to personal integrity. For medical personnel and the general public, unfortunate confusion may arise between episodes of mass hysteria and the psychiatric diagnosis of hysteria.We therefore propose that the term "collective stress syndrome" be adopted to describe outbreaks of illness formerly referred to as mass hysteria. The use of collective stress syndrome may result in a reduction of defensiveness and anger, thereby facilitating a more reasoned analysis of events and predisposing causes. We believe that enhanced communication will result when the stigma of hysteria is replaced by the generally well-accepted